title: Growth hormone deficiency in adults with thalassemia: an overview and the I-CET recommendations.
abstract: This review paper provides a summary of the current state of knowledge regarding GHD provides recommendations for the diagnosis and treatment of GHD in adult patients with thalassaemia major (TM). The reported prevalence of adult GHD and /or IGF-I deficiency in TM patients varies from 8% to 44 % in different centers. Because GH treatment requires analysis of many factors, including the effect of treatment on cardiac functions, metabolic parameters and psychosocial functioning, along with safety, ethical considerations, financial cost and other burdens of therapy, stringent diagnostic criteria are needed. The authors report the diagnostic recommendations of the International Study Group of Endocrine Complications in Thalassemia (I-CET) for adult TM patients.The pros and cons of GH treatment must be discussed with each patient, after which GH doses should be individualized and titrated to maximum efficacy with minimal side effects. Prospective studies to monitor potential benefits versus possible side-effects will enable endocrinologists to define recommendations on dosage and the long term effects, particularly on cardiovascular and bone status of GH therapy in adult TM patients.
authors.affiliation: Department of Pediatrics, Division of Endocrinology, Hamad General Hospital Doha, Qatar; Pediatric, Endocrinology and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy; Department of Pediatrics, Ain Shams University, Cairo, Egypt; Department of Paediatrics, Division of Pediatric Endocrinology, Makarios Hospital, Nicosia, Cyprus; Department of Hematology, Alamal Hospital, Hamad Medical Center, Doha, Qatar; Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pediatrics, Dayanand Medical College, Ludhiana, Punjab, India; Department of Pediatrics, Pugliese-Ciaccio Hospital, Catanzaro, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Soliman
authors.forename: V
authors.initials: V
authors.lastname: De Sanctis
authors.forename: H
authors.initials: H
authors.lastname: Elsedfy
authors.forename: M
authors.initials: M
authors.lastname: Yassin
authors.forename: N
authors.initials: N
authors.lastname: Skordis
authors.forename: M
authors.initials: M
authors.lastname: Karimi
authors.forename: P
authors.initials: P
authors.lastname: Sobti
authors.forename: G
authors.initials: G
authors.lastname: Raiola
authors.forename: M
authors.initials: M
authors.lastname: El Kholy
mesh_terms: D000328:Adult; D004393:Dwarfism, Pituitary / Q000097:blood / Q000150:complications / Q000188:drug therapy; D019382:Human Growth Hormone / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic; D011994:Recombinant Proteins / Q000493:pharmacokinetics / Q000627:therapeutic use; D013789:Thalassemia / Q000097:blood / Q000150:complications*
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone